Depression Doesn’t Play Favorites: An Exclusive Interview with a Depression Sufferer
May 12, 2008 by Liberty Kontranowski
Filed under Blogosphere, Depression, Event, Mental Health, Psychology, Relationships, Theme Days, Your Mind
Tomorrow is theme day once again here at the b5media Health & Wellness channel and this month is all about depression. Not a sunny topic, I know, but one that is vitally important and has most likely touched each and every one of us in some way or another.
Thus, I am so honored to have been able to interview Tristram Hussey, our very own blogger training extraordinaire. Tris has been suffering with depression for many years and has some incredibly valuable insight to share regarding diagnosis, treatment, triggers and more. Tris’s hope is that if this interview helps even one person see a doctor for treatment, we have accomplished something great. Indeed, Tris.
And now, the interview:
1. Depression is often considered a quiet disease or one that many folks live with for quite some time without treatment. Have you found that to be the case with you, and if so, how did you finally decide to seek treatment?
Personally I lived with depression from when I was in my teens until my mid-30s, yes a very, very long time. I figured I could handle it. I knew that I suffered from more than just the blues, but I also didn’t want to take medication. I was afraid that the medications would mess around with the one thing I treasured–my mind. What I didn’t know was that the medications just help my brain work better.
Why did I finally get help? Frankly I hit rock bottom. My marriage was falling apart and my professional life was not going well. Finally I went to my doctor. The best decision of my life, it probably saved my life.
2. Why do you believe people wait so long to seek treatment?
There are lots of reasons, especially for men, the biggest I think is the stigma of being “mentally ill”. Men also don’t want to feel like being less of a man or that they “can’t handle it” themselves.
Even though many, many men and women suffer from and are treated for depression, the stigma is still there. This is one reason that I talk openly about it. I suffer from depression, I take medication, and I’m okay.
2. Do you believe depression is caused by a chemical imbalance in the brain or by circumstances? Or both?
For me, the cause is chemical, but the triggers are circumstances. You can have “situational depression” and still need help to get out of it. So, it is both. And, for me, the chemical reasons make it easier to grapple with.
3. Once you’ve received treatment for depression, are you “cured” or is recovery an ongoing process?
I don’t know about being cured. Maybe for people who have something related to a specific event, but for me, it’s going to be the rest of my life. Will I be able to reduce my medication in the future? Maybe. That is something that I work with my doctor on. Working with your doctor is critical to success.
4. What are some triggers you’ve experienced?
Read Tris’s answer to this question and the remainder of the interview after the fold…
For me it’s stress and the downturns of life. That’s when I know I’ve done the right thing by treating this. Something that would have knocked me flat for days, we all get the blues sometimes, might only last a day or so.
Life isn’t perfect, and medication can’t or doesn’t fix everything, but it helps keep things in check.
5. What are some treatments you’ve tried, both naturally and medically-based? What seemed to work best for you and which would you consider a last resort?
I’ve tried various SSRIs and SSNRIs along with counseling. I like the newer drugs, but, all medications have side effects. My worst one is night sweats, which in the great scheme of things isn’t too bad.
Sexual dysfunction? Yes, very common. And yes, it can be an issue.
The thing with depression meds is that they don’t, and can’t, work overnight. It takes about a month for them to start kicking in and the first two weeks can be hell. When you start taking meds, you have to be ready for the nausea and other initial side effects, and just push through them.
Another very, very important thing about depression meds is do not stop taking them without talking to your doctor. The withdrawal symptoms are real and suck. That’s even before the emotional roller coaster starts. When I’ve forgotten to take my meds, I know in about 4 hours.
I haven’t tried natural remedies and don’t know if I’d suggest them.
6. Do you have any statistics or depression-related facts you care to share?
I wish I knew about prevalence, but I do know that 30% of people with depression commit suicide. That is a sobering stat, and one that haunts me. Haunts me every day. This is one reason that I keep tabs on how I’m feeling, ask for help, and adjust my meds with my doctor if needed.
7. How has depression affected your relationships and/or work?
Before I got help, I just wasn’t a fun person to be around when the dark times hit. I would get down, and just not able to function well. One thing about depression is that social anxiety often goes hand in hand with it. The newer drugs help with that too.
Before, I had trouble concentrating, getting things done, and just making those connections needed for work. Now, well on my down days, people understand. I work with very understanding people. Sometimes I just have to take a break (mental health day is apt). However, on “normal” days, I have focus, energy, drive, and passion. The meds have really helped me.
8. If you could give any one person who may be “feeling blue” advice, what would it be?
See. Your. Doctor. Ask. For. Help. You’re not alone. You can get help. And it can get better. Talk to a friend, talk to your doctor.
Yes, everyone gets the blues. Everyone gets down. But if you can’t shake it, or thinking about hurting yourself. You must get help.
It will take tremendous courage to do it, but your family and friends, the people who love you, will be there for you.
***
Special thanks once again to Tris for taking the time to share such a personal side of himself with us. Readers, if you have any comments or questions, please, please don’t hesitate to leave them below. We encourage conversation here at Healthbolt and would love to hear from you.
You can catch more from Tris at Manscaping 101.com, MapleLeaf 2.0, and A View from the Isle.
Tris thanks for sharing and helping to bring discussion about depression out in the open. As you say, everyone gets the blues. But when you can’t shake it, it’s time to ask for help…
First, Lib thank you for the chance to tell my story. Liz, you’re welcome. Again if one person reads this and says to themselves, maybe it’s time to get help, then I’m happy.
Tris thanks for being so candid. I see more and more people drowning in depression and feeling so isolated. I think it helps to hear different stories and personal experiences – not just from relatives, but strangers to see just how this illness isn’t prejudice in any way.
Current Depression Medications: Are SSRIs More Beneficial Than Deadly?
Presently, for the treatment of depression and other what some claim are other types of mental disorders, as some claim certain mental disorders are somewhat questionable, selective serotonin reuptake inhibitors(SSRIs) are the drugs of choice by most prescribers today. Such meds, meds that affect the mind are called psychotropic medications. SSRIs also include a few meds in this class with the addition of a norepinephrine uptake inhibitor added to the SSRI, and these are referred to SNRI medications, which combined with SSRIs, are the number 1 top therapeutic class of prescriptions presently. While there are several available SSRIs presently, two SNRIs available are Cymbalta and Effexor. Some consider these classes of meds a next generation mood enhancer after the benzodiazepine hype decades ago, as there are similarities regarding their intake by others, yet the mechanisms of action are clearly different, but not their continued use by others. Furthermore, regarding SNRIs, adding the additional agent of norepinepherine is presumed to increase the effectiveness of SSRIs by some.
Some Definitions:
Serotonin is a neurotransmitter thought to be associated with mood. The hypothesis was first suggested in the mid 1960s that this neurotransmitter may play a role in moods and emotions in humans. Yet to this day, the serotonin correlation with such behavioral and mental conditions is only theoretical. In fact, the psychiatrist’s bible, which is known as the DSM, states that the definite etiology of depression remains a mystery and remains unknown with complete certainty. So a chemical imbalance in the brain is not proven to be the cause of mood disorders, it is only suspected as a result of limited scientific evidence. In fact, diagnosing mental diseases such as depression is based on subjective assessment only, as interpreted by the prescriber, so one could question the accuracy of such diagnoses.
Norepinepherine is a stress hormone, which many believe help those who have such mood disorders as depression. Basically, with the theory that by adding this hormone, the SSRI will be more efficacious for a patient prescribed such a med, as suggested earlier.
And depression is only one of those mood disorders that may exist in certain patients, yet possibly the most devastating one. An accurate diagnosis of these mood conditions lack complete accuracy, as they can only be defined conceptually, so the diagnosis or impression concluded by the patient’s doctor is dependent on subjective criteria, such as questionnaires and patient observation. A social patient history is uncertain and tricky as well, some have said. There is no objective diagnostic testing for depression. Yet the diagnosis of depression in patients has increased quite a bit over the past few decades. Also, few would argue that depression does not exist in other people to the degree that the affected patient believes their mental condition is presently. Yet, one may contemplate, actually how many people are really depressed? What is believed is that if one is disabled or impaired from a mental paradigm, treatment is necessary and appropriate with medication.
In Time magazine’s June 16th 2008 cover story, it was reported that the military personnel in the Iraq war are pounding down SSRIs often. Every time there is a new war, there is a new drug, it seems.
Several decades ago, less than 1 percent of the U.S. population were diagnosed with depression, some have said. Today, it is believed that about 10 percent of the total population in the United States have or have experienced depression at some time in their lives that may vary in severity and longevity. Why this great increase in the growth of this condition remains unknown and is subject to speculation.
What is known is that the psychiatry specialty is the one specialty most paid to by certain pharmaceutical companies for ultimately and eventual support of their psychotropic meds that they currently promote to these doctors, as this aspect of the pharmaceutical industry clearly desires market growth of these products.
Regardless, SSRIs and SRNIs are the preferred treatment methods if depression or other mood disorders are suspected by a health care provider. Yet these meds discussed clearly are not the only treatments, medicinally or otherwise, for depression and other related and suspected disease states.
Over 30 million scripts of these types of meds are written annually, and the franchise is around 20 billion dollars a year now, along with some of the meds costing over 3 dollars per tablet. There are about ten different SSRI/SRNI meds available, many of which are now generic, yet essentially, they appear to be similar in regards to their efficacy and adverse events. The newest one, a SNRI called Pristiq, was approved in 2008, and is believed to be launched as a treatment for menopause. The first one of these SSRI meds was Prozac, which was available in 1988, and the drug was greatly praised for its ability to transform the lives of those who consumed this medication in the years that followed. Some termed Prozac, ‘the happy pill’. In addition, as the years went by and more drugs in this class became available, Prozac was the one of preference for many doctors for children. A favorable book was published specifically regarding this medication soon after it became so popular with others.
Furthermore, these meds have received upon request of their manufacturers additional indications besides depression for some really questionable conditions, such as social phobia and premenstrual syndrome. With the latter, I find it hard to believe that a natural female experience can be considered a treatable disease. Social phobia is a personality trait, in my opinion, which has been called shyness or perhaps a term coined by Dr. Carl Jung, which is introversion, so this probably should not be labeled a treatable disease as well. There are other indications for certain behavioral manifestations as well with the different SSRIs or SRNIs. So the market continues to grow with these meds. Yet, it is believed that these meds are effective in only about half of those who take them, so they are not going to be beneficial for those suspected of having certain medical illnesses treated by such meds. The makers of such meds seemed to have created such conditions besides depression for additional utilization of these types of medications, which is a process known as disease mongering. Drug companies that make these medications are active and have been active in forming mutual relationships with related disease- specific support groups, such as providing financial support for screenings for the indicated conditions of their meds- which includes the screening of children and adolescents in particular, I understand. As a layperson, I consider such activities dangerous and inappropriate for several reasons.
Danger and concerns by others with these psychotropics primarily involves the adverse effects associated with these types of meds, which include suicidal thoughts and actions, violence, including acts of homicide, and aggression, among others, and the makers of such drugs are suspected to have known about these effects and did not share them with the public in a timely and critical manner. While most SSRIs and SNRIs are approved for use in adults only, prescribing these meds to children and adolescents has drawn the most attention and debate with others, such as those in the medical profession as well as citizen watchdog groups. The reasons for this attention are due to the potential off-label use of these meds in this population, yet what may be most shocking is the fact that some of the makers of these meds did not release clinical study information about the risks of suicide as well as the other adverse events related to such populations, including the decreased efficacy of SSRIs in general, which is believed to be less than 10 percent more effective than a placebo. Paxil caught the attention of the government regarding this issue of data suppression some time ago, this hiding such important information- Elliot Spitzer specifically was the catalyst for this awareness, as I recall. Furthermore, that drug is in the spotlight once again years later. Some believe the drug maker knew about possible risk to the youth as early as 1991.
And there are very serious questions about the use of SSRIs in children and adolescents regarding the possible damaging effects of these meds on them. For example, do the SSRIs correct or create brain states considered not within normal limits, which in effect could cause harm rather than benefit? Are adolescents really depressed, or just experiencing what was once considered normal teenage angst? Do SSRIs have an effect on the brain development and their identity of such young people? Do adolescents in particular become dangerous or bizarre due to SSRIs interfering with the myelination occurring within their still developing brains? No one seems to know the correct answer to such questions, yet the danger associated with the use of SSRIs does in fact exist. It is observed in some who take such meds, but not all who take these meds. Yet health care providers possibly should be much more aware of these possibilities, possibly, along with the black box warning now on SSRI prescribing information for the youth that has existed since 1994.
Finally, if SSRIs or SNRIs are discontinued by a patient without medical supervision, withdrawals are believed to be quite brutal, and may be a catalyst for suicide in itself, as not only are these meds habit forming, but discontinuing these meds abruptly, I understand, leaves the brain in a state of neurochemical instability, as the neurons are recalibrating upon discontinuation of the SSRI or SNRI that altered the brain of the consumer of this type of med. This occurs to some degree with any psychotropic med, yet the withdrawals can reach a state of danger for the victim in some classes of meds such as SSRIs and SNRIs, it is believed.
SSRIs and SRNIs have been claimed by doctors and patients to be extremely beneficial for the patient’s well -being regarding the patient’s mental issues where these types of meds are used, yet the risk factors associated with this class of medications may outweigh any perceived benefit for the patient taking such a drug. Before these medications mentioned were developed, doctors praised trycyclics, another class of anti-depressants, in a similar manner some time ago. Considering the lack of efficacy that has been demonstrated objectively with the newer psychotropics, along with the deadly adverse events with these SSRI and SSNI meds only recently brought to the attention of others, other treatment options should probably be considered, but that is up to the discretion of the prescriber.
It is my hope that such a prescriber rules out possible other etiologies for their patients’ mental conditions before they conclude that such a patient is suffering from true mental illness requiring the medications mentioned earlier, such as asking their patients about life stressors and other medications these patients have taken in the past, for example. Because at times, a doctor can in fact do harm without intent.
“I use to care, but now I take a pill for that.” —
Author unknown
Dan Abshear
Author’s note: What has been written is based upon information and belief